Surviving the Extremes: A Doctor's Journey to the Limits of Human Endurance Read Free Page B

my worlds was the “other” one. Dr. Kamler’s adventure stories always circulated quickly around the medical community, often embroidered with more detail and infused with more drama than my original accounts. Increasingly I felt like an outsider in the traditional, medical world from which I had come. Sometimes my New York practice seemed the more alien environment. However, something very interesting happened. Doctors pinned down by heavy mortgage payments and high overheads sought me out for vicarious relief. They understood why I did what I did. They shared my curiosity about what happens to the human body at the limits of medicine and felt the same longing for adventure in places far from their waiting rooms.
    The earth’s harshest and least explored environments—above sea level, at any rate—tend to contain mountains. Many of the expeditions I have found most intriguing involved rugged mountaineering, making climbing proficiency a required skill for a doctor practicing extrememedicine. I climbed in the Alps, the Andes, and Antarctica, joining the tight community of high-altitude climbers. No matter what hemisphere I was in, I would run into the same people.
    Several years ago, by word of mouth, I heard of an expedition being put together, sponsored in part by
National Geographic,
to study the tectonics of Mount Everest and measure its exact height using a laser telescope. The climbing would be difficult, but the research would be valuable, and the challenge of providing medical care would be as enormous as the mountain itself. My phone call to the expedition leader struck him, he later told me, as divine intervention. Though he had a clear scientific objective, adequate funding, and supremely qualified climbers, he had not yet solved the problem of medical supervision. I would be the only team member he hadn’t already climbed with and my climbing resume was a little thin by his standards, but he was still eager to have me. He had been to Everest before and told me how quickly bad things can happen on big mountains, even to experienced people. He was right. Only one day after we arrived in base camp, with most of my supplies still in boxes, Pasang fell into a crevasse. I was yet again treating someone in a hostile, unforgiving environment and discovering—yet again—the body’s enormous capacity for survival.
    That discovery forms the core of this book. We are going on a journey into the most remote and dangerous regions of the world, and then continuing on into the bodies and minds of the people who are there, people for whom that environment is very real and very life-threatening. Some of the stories are journeys I have made myself, some are based upon the experiences of others: climbers, divers, sailors, explorers, astronauts, as well as ordinary people who found themselves in extraordinary circumstances. Woven throughout are observations and reflections on the evolutionary biology, physiology, and psychology that combine to give humans the means to prevail, whether it is in an acute response to an attack from a force of nature, or a long-term adaptation to a chronic stress in the environment. We will cross the human threshold to see how the body works under normal
load-bearing
conditions, how it moves into overdrive when subjected to environmental insults, and, finally, what happens when the body breaksdown—overwhelmed by extreme environmental forces it was never designed to withstand.
    The tried-and-true method for dealing with extreme environments is to avoid them. Apart from the occasional hapless wanderer, this approach has worked well for the human species over a few hundred thousand years. People who live on the edges of these no-man’s-lands have adapted to their particular environmental stresses through natural selection, but it made no sense to venture any farther inside to a place offering no food or shelter. And there was no good way to get there, in any case. Ocean depths, remote deserts,